Definition

Trachoma is a bacterial infection of the eye.

Alternative Names

Granular conjunctivitis; Egyptian ophthalmia; Conjunctivitis - granular

Causes, incidence, and risk factors

Trachoma is caused by infection with the bacteria Chlamydia trachomatis.

The condition occurs worldwide, mostly in rural settings in developing countries. It frequently affects children, although the effects of scarring may not be seen until later in life. While trachoma is rare in the United States, certain populations marked by poverty, crowded living conditions, or poor hygiene are at higher risk for this illness.

Trachoma is spread through direct contact with infected eye, nose, or throat secretions or by contact with contaminated objects, such as towels or clothes. Certain flies can also spread the bacteria.

Symptoms

Symptoms begin 5 to 12 days after being exposed to the bacteria. The condition begins slowly as inflammation of the tissue lining the eyelids (conjunctivitis, or "pink eye"), which if untreated may lead to scarring.

Symptoms may include:

Cloudy cornea
Discharge from the eye
Swelling of lymph nodes just in front of the ears
Swollen eyelids
Turned-in eyelashes

Signs and tests

An eye exam may reveal scarring on the inside of the upper eye lid, redness of the white part of the eyes, and new blood vessel growth into the cornea.

Laboratory tests are needed to accurately identify and detect the bacteria and diagnose trachoma.

Treatment

Antibiotics can prevent long-term complications if used early in the infection. Antibiotics include erythromycin and doxycycline. In certain cases, eyelid surgery may be needed to prevent long-term scarring, which can lead to blindness if not corrected.

Expectations (prognosis)

Early treatment before the development of scarring and lid deformities has an excellent prognosis.

Complications

If the eyelids are severely irritated, the eyelashes may turn in and rub against the cornea. This can cause eye ulcers, additional scars, vision loss, and possibly, blindness.

Calling your health care provider

Call your health care provider if you or your child recently visited an area of the world where trachoma is common and there are symptoms of conjunctivitis.

Prevention

Improved sanitation and not sharing items such as towels are important measures for limiting the spread of trachoma.

References

Diseases Caused By Chlamydiae. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 339.

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